EHR Experts

The National Institute of Standards and Technology recently published two guides designed to help vendors of electronic health records make their products easier to use, Health Data Management reports (Goedert, Health Data Management, 12/10).

NIST worked with the Office of the National Coordinator for Health IT and the Agency for Healthcare Research and Quality on the reports.

NIST Guides

The first NIST report — titled “NIST Guide to the Processes Approach for Improving the Usability of Electronic Health Records” — provides guidance on user-centered design principles for EHR applications (Monegain, Healthcare IT News, 12/10). The report notes that an EHR with a user-centered design would need to:

• Understand user needs, workflows and work environments;
• Engage users;
• Set user performance objectives;
• Provide a user interface that is based on human behavior principles;
• Conduct usability tests to measure how well the interface meets user needs; and
• Adapt the design over time until performance objectives are fulfilled (Byers, CMIO, 12/9).

The second NIST report — titled “Customized Common Industry Format Template for Electronic Health Record Usability Testing” — provides a standard reporting template called the Common User Industry format that can be used to test EHR systems (Healthcare IT News, 12/10).

Related AHRQ Report

In related news, AHRQ recently released a report that identifies shortfalls in the processes that EHR vendors use to ensure usability.

The report — titled “Electronic Health Record Usability: Vendor Practices and Perspectives” — noted that the health IT industry lacks standard approaches and formats for testing and reporting EHR usability (CMIO, 12/9).

Source    :    http://www.ihealthbeat.org/articles/2010/12/13/federal-agencies-offer-guidance-on-improving-usability-of-ehr-tools.aspx

Filed under: EHR, EHR companies, Electronic Health Records on March 4th, 2011 | No Comments »

Hospitals and physician practices that implement electronic health records could see their costs increase for medical liability insurance, at least over the short term, according to a recent report from Conning Research and Consulting, NextGov’s “Health IT Update” reports.

The report notes that underwriters for medical liability insurance are concerned that software failures and medical coding errors could occur more frequently during the early stages of EHR implementation, which could lead to an increase in medical liability claims. The report predicts that the frequency of such errors will decrease over time.

In addition, the report suggests that medical liability claims could increase as patients gain greater access to their EHRs. Some patients might file lawsuits against health care providers who fail to follow treatment protocols outlined in EHRs.

The report also suggests that the cost of defending medical liability claims could increase as more lawyers begin using data from electronic sources (Pulley, “Health IT Update,” NextGov, 11/30).

Source    :    http://www.ihealthbeat.org/articles/2010/12/1/adoption-of-ehrs-could-boost-costs-for-medical-liability-insurance.aspx?topic=physician%20practices

Filed under: EHR, EHR companies, Electronic Health Records on March 1st, 2011 | No Comments »

The State Department plans to deploy an electronic health record system worldwide for its medical offices to improve the quality and efficiency of the healthcare it delivers to its 50,000 diplomatic and federal employees and their families.

Besides primary care, the department provides mental health services, coordination of local medical care, medical evacuations and medical clearance assessments.

State has requested information from vendors about the features and functionality of commercial ambulatory EHRs that could deliver the services the department needs, according to an announcement Dec. 1 in the Federal Business Opportunities Web site.

State said it will use the EHR in health units at U.S. embassies and consulates in 170 countries.

Those overseas health units vary in size and capabilities. For example, large Medevac centers coordinate medical evacuations in addition to primary healthcare and are staffed with physicians and other Foreign Service health practitioners, psychiatrists, locally hired nurses, and administrative personnel, according to the notice.

Large health units, which hire local clinical personnel in addition to Foreign Service practitioners, supply primary care, local hospitalization and regional administrative support.

However, medium health units have limited Foreign Service and locally hired clinical personnel for primary care and evacuate hospitalizations or complex cases, according to State. Small health units, often at a consulate or embassy in a small country, may only have a local nurse and occasionally a local physician, and only provide immunizations and first aid care.

Source    :    http://www.govhealthit.com/newsitem.aspx?tid=10&nid=75514

Filed under: EHR, EHR companies, Electronic Health Records on February 16th, 2011 | No Comments »

The Centers for Medicare and Medicaid Services wants industry help in digitizing clinical quality measures so healthcare providers can send them to CMS directly from their electronic health record systems.

CMS needs to develop technical descriptions for the quality measures in order to guide vendors in how to incorporate the reporting function in their electronic health record (EHRs) products, according to the agency in an announcement Nov. 2 on the Federal Business Opportunities Web site.

Certified EHRs must be capable of calculating results for quality measures from electronic patient information. The work sought by CMS would help streamline the process by which providers could meet pending criteria for meaningful use and other performance-based incentive programs.

To be able to report quality measures from an EHR, CMS said, the specifications should include data elements describing clinical concepts in a standard format so providers can monitor their performance; algorithms to enable providers to calculate quality measure performance; and definitions of measures that can be stored in the EHR so data can be sent or shared electronically in a standard format.

CMS also wants another set of technical descriptions to help it move to a single standard for describing a patient’s health status from an inpatient EHR.

In doing so, CMS plans to offer electronic specifications to guide vendors and providers in how to move to the agency’s preferred Continuity Assessment Record and Evaluation (CARE) standard so it can be included in inpatient EHRs.

CARE is a tool to portray a patient’s health and functional assessment. It is made up of standard data elements that providers collect and transmit to CMS about the status of patients who, when they are discharged from a hospital, continue on to other healthcare services like nursing homes, rehabilitation centers, and home health care to complete their convalescence.

Source  :  http://www.govhealthit.com/newsitem.aspx?tid=10&nid=75023

Filed under: EHR, EHR companies, Electronic Health Records on January 31st, 2011 | No Comments »

Slightly more than half of office-based physicians in the U.S. report using electronic health records in their practices, a slight increase over last year, according to preliminary results of a survey by CDC’s National Center for Health Statistics, United Press International reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

For the National Ambulatory Medical Care Survey, researchers surveyed more than 10,300 physicians by mail and telephone from April through July of this year (United Press International, 12/9).

Key Results

For the survey, an EHR system was defined as being all or partially electronic (CDC report, December 2010).

The survey found that 50.7% of physicians reported using all or partial EHR systems for patient files in their practices. That figure is up from 48.3% in 2009.

This year, nearly 25% of survey respondents said their systems met criteria for a “basic” system, while 10.1% said their systems met criteria of a “fully functional” system. Both of these rates are higher than last year’s 21.8% and 6.9%, respectively, according to the survey (United Press International, 12/9).

System Features

A basic EHR system was defined as having the ability to:

• View imaging and lab results;
• View medication lists; and
• Perform other duties (McKinney, Modern Healthcare, 12/10).

A fully functional EHR system was defined as having the ability to:

• Electronically order tests;
• Provide drug interaction warnings; and
• Perform other duties (CDC report, December 2010).

Variations Across U.S.

The survey found widespread variation for EHR adoption among states. The percentage of physicians by state reporting use of a basic EHR system ranged from 12.5% to 51.5%, according to the survey (United Press International, 12/9).

Source  :  http://www.ihealthbeat.org/articles/2010/12/10/cdc-survey-finds-physician-use-of-ehrs-up-slightly-from-2009.aspx

Filed under: ARRA, CCHIT, EHR, EHR companies, Electronic Health Records on January 20th, 2011 | No Comments »

FOR IMMEDIATE RELEASE: January 5, 2011
Media Contact:
Ted Dave
pr@omnmd.com
tdave@omnimd.com

January 5, 2011 – Integrated Systems Management Inc announced today that OmniMD™ EHR, Version 11.0 is 2011/2012 compliant and was certified as a Complete EHR on January 4, 2011 by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, in accordance with the applicable (eligible provider) certification criteria adopted by the Secretary of Health and Human Services. The 2011/2012 criteria support the Stage 1 meaningful use measures required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA).

According to Divan Dave, CEO, of OmniMD™ “This certification is another step in our commitment to provide providers with intuitive, easy-to-use, affordable technologies that help them improve patient care, reduce their costs and qualify for government incentives”.

The ONC-ATCB 2011/2012 certification program tests and certifies that Complete EHRs meet all of the 2011/2012 criteria and EHR Modules meet one or more – but not all – of the criteria approved by the Secretary of Health and Human Services (HHS) for either eligible provider or hospital technology.

“CCHIT is pleased to be testing and certifying products so that companies are now able to offer these products to providers who wish to purchase and implement certified EHR technology and achieve meaningful use in time for the 2011-2012 incentives,” said Karen M. Bell, M.D., M.S.S., Chair, CCHIT.

OmniMD™ EHR, Version 11.0 certification number is CC-1112-484340-1. ONC-ATCB 2011/2012 certification conferred by CCHIT does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments.

The clinical quality measures to which OmniMD™ has been certified include:

NQF 0421 – Adult Weight Screening & Follow-Up
NQF 0013 – Hypertension: Blood Pressure Measurement
NQF 0028 – Tobacco Use Assessment and Cessation
NQF 0041 – Influenza Immunization
NQF 0024 – Weight Assessment and Counseling
NQF 0038 – Childhood Immunization Status
NQF 0034 – Colorectal Cancer Screening
NQF 0043 – Pneumonia Vaccination Status
NQF 0067 – CAD: Oral Antiplatelet Therapy
NQF 0084 – Heart Failure: Warfarin Therapy

OmniMD™ EHR Version 11.0 is also certified in CCHIT’s separate and independently developed certification program. OmniMD™ Version 11.0 is a pre-market CCHIT Certified® 2011, Ambulatory EHR. Integrated Systems Management Inc. has certified its EHR technology in both programs to provide greater assurance to its customers.

About Integrated Systems Management, Inc

Founded in 2000, OmniMD™ integrated Electronic Health Records and Practice Management (PMS) products and services, offers unparalleled reliability, ease-of-use, efficiency and customizability. OmniMD™ Ambulatory EHR has also earned a designation as a pre-market CCHIT 2011 Certification with the highest 5 Star Usability Rating ensuring OmniMD™ commitment to have a comprehensive, secure, scalable, intuitive and interoperable EHR system. OmniMD™ Ambulatory EHR Version 11.0 is CCHIT 2011 Pre-Market Certified, web-enabled and support devices ranging from Tablet PCs to Smart phones. OmniMD™ offers a comprehensive set of services such as Health Transcriptions, Document Management, Patient Portal, Patient Reminder and Eligibility Verification as part of an integrated solution under one roof helping practices to effectively addressing their financial, administrative, clinical, and regulatory needs. OmniMD™ Ambulatory EHR Version 11.0 is built as a true Software as a Service solution.  It can be deployed as an Enterprise or a Subscription based Service as per the practice requirements.  OmniMD™ is designed to exceed the present and future needs of the healthcare industry. OmniMD™ is robust, scalable, interoperable, secure, intuitive and customizable with rapid deployment model. OmniMD™ EHR has also achieved Surescripts® Gold Solution Provider status, which allows for interoperability with the nation’s community pharmacies – improving the safety, efficiency and quality of the prescribing process. Gold Solution Provider status is granted to vendors whose software products have surpassed Surescripts’ baseline product certification, by demonstrating a higher level of commitment to e-prescribing, enhanced security, excellent customer support and service. OmniMD™ is a division of Integrated Systems Management, Inc. – ISM Inc. – (www.ismnet.com) a leader in Software Development and Information Technology Consulting since 1989.

About CCHIT

The Certification Commission for Health Information Technology (CCHIT®) is an independent, 501(c)3 nonprofit organization with the public mission of accelerating the adoption of robust, interoperable health information technology.  The Commission has been certifying electronic health record technology since 2006 and is approved by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS) as an Authorized Testing and Certification Body (ONC-ATCB).  More information on CCHIT, CCHIT Certified® products and ONC-ATCB certified electronic health record technology is available at http://cchit.org.

About ONC-ATCB 2011/2012 certification

The ONC-ATCB 2011/2012 certification program tests and certifies that EHR technology is capable of meeting the 2011/2012 criteria approved by the Secretary of Health and Human Services (HHS). The certifications include Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology and EHR Modules, which meet one or more – but not all – of the criteria. ONC-ATCB certification aligns with Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology published in the Federal Register in July 2010 and strictly adheres to the test procedures published by the National Institute of Standards and Technology (NIST) at the time of testing.   ONC-ATCB 2011/2012 certification conferred by the Certification Commission for Health Information Technology (CCHIT®) does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments.

“CCHIT®” and “CCHIT Certified®” are registered trademarks of the Certification Commission for Health Information Technology.

Filed under: ARRA, CCHIT, EHR, EHR companies, Electronic Health Records, Health Care on January 6th, 2011 | No Comments »

Integrated healthcare delivery organizations say electronic health records (EHRs) support their patient care strategies by increasing the availability of individual patient and patient population data and by improving communication among providers.

These findings are from a U.S. Government Accountability Office (GAO) report, Health Care Delivery: Features of Integrated Systems Support Patient Care Strategies and Access to Care, but Systems Face Challenges.

The GAO examined 15 private and public integrated delivery systems (IDSs) that are clinically aligned across primary, specialty, and acute care. These healthcare organizations vary in their degree of integration, specific organizational features, and payer mix (such as the extent to which they serve Medicare and Medicaid beneficiaries and the uninsured).

The report offers a glimpse into how chief medical officers and other systems officials are using digitized medical records, as well as their evaluation of the impact of EHRs on patient care, including care coordination, disease management, and use of care protocols.

All 15 IDSs reported having, to some extent, implemented EHRs. Officials at some IDSs said using EHRs helps their care coordination strategies because they make patient information more readily available and thereby improve communication among providers, staff, and patients.

One example is Denver Health, a public hospital in Colorado. Denver Health uses its EHR system to support care coordination by scanning within 24 hours of patient contact physician notes from patient encounters and making clinical information, such as previous laboratory tests, available to all providers. An official from the Mayo Clinic, Rochester Region, based in Rochester, Minn. told GAO that the information in its EHR system helps avoid overutilization and duplication of services.

Similarly, Marshfield Clinic, a private healthcare facility, makes EHRs available at its locations in central, western, and northern Wisconsin. The EHR system gives providers access to clinical information, digital radiology images, and capabilities such as e-prescribing. The report said that at Marshfield Clinic, each patient’s EHR contains a dashboard to highlight needed services and to facilitate communication and collaboration among providers. Marshfield’s EHR also generates a list of high-risk patients in need of interventions so that physicians and other staff can follow up with those patients.

IDS officials said EHRs facilitate disease management by making patient-level and population-level data available to providers, which allows providers and IDSs to adjust approaches to treatment based on individual patient and population-wide progress.

Because the EHR provides real-time clinical information, providers are able to see test results immediately upon completion, which might not be possible without an EHR. Having real-time information allows providers to initiate appropriate treatment or follow-up, and to anticipate and mitigate potential problems, more easily and much earlier.

Respondents reported that using EHRs with e-prescribing and computerized physician order entry (CPOE) capabilities reduces errors and lowers costs. And some said that their EHRs facilitate the use of care protocols and clinical practice guidelines by prompting providers to use them and tracking their use.

However, respondents said implementing an EHR system is financially and operationally challenging. They also cited challenges related to sharing the clinical information in patients’ EHRs with providers outside of their systems. Some IDS officials said that, while they make their EHRs available to outside providers who also treat their patients, these outside providers can read the EHRs, but cannot directly enter clinical information to update a patient’s medical notes.

Source    :     http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=228300451&queryText=e%20prescribing

Filed under: EHR, EHR companies, Electronic Health Records on January 4th, 2011 | No Comments »

CHICAGO – The Certification Commission for Health Information Technology (CCHIT), one of three government designated certification entities, says it will launch a new custom EHR certification program for hospitals on Dec. 15.

CCHIT will introduce the program at a Town Call webcast and teleconference Dec. 1 at 1 p.m. Eastern Time.

CCHIT’s EHR Alternative Certification for Hospitals, or EACH program, an ONC-ATCB 2011/2012 certification for installed hospital EHR technology, is designed to meet the needs of hospitals that have uncertified legacy software, customized commercial products, or have developed their own EHR systems.

“Until now, CCHIT’s ONC-ATCB certification was available only for health IT vendor developed products,” said Alisa Ray, executive director, CCHIT. “Our new certification program is an alternative for hospitals that have developed their systems with products that are not individually certified or are a mix of certified and uncertified products. These hospital EHR systems are often very sophisticated and may have been developed over many years. Yet, they must be certified for hospitals to qualify for financial incentives through the American Recovery and Reinvestment Act (ARRA), and avoid Medicare penalties.”

“Hospitals certifying products in this new program can be assured that they meet a critical first step in qualifying for ARRA incentive payments and that their EHR technology is prepared to support the achievement of meaningful use by its clinicians,” Ray added.

Alternative certification is not needed if a hospital has adopted an EHR with complete certification, or a combination of certified EHR modules that meet all of the 2011/2012 certification criteria.

CCHIT has been certifying EHR technology since 2006 and was approved by the HHS Office of the. National Coordinator for HIT (ONC) as an Authorized Testing and Certification Body (ONC-ATCB) on Sept. 3, 2010. To date, CCHIT has certified 66 products offered by health IT companies.

Source   :    http://www.healthcareitnews.com/news/cchit-launch-custom-ehr-certification-hospitals

Filed under: CCHIT, EHR, EHR companies, Electronic Health Records on December 29th, 2010 | No Comments »

Medical practices that have avoided implementing an electronic health record system (EHR) because of the associated costs may not have such a strong argument, according to a study published by the Medical Group Management Association (MGMA). Data collected from both hospital/IDS-owned and independent practices indicates that practices that have implemented an EHR system produced better financial results than those that have not.

Multi-specialty and single-specialty practices, including primary care, nonsurgical, and surgical specialties with an EHR had almost $50,000 more in operating margin—total medical revenue per full-time-equivalent (FTE) physician—than practices that still use paper medical records.

And while overall expenses rose among EHR-enabled practices (approximately $106,000 per FTE physician), median revenue per FTE physician was also greater at $179,000 for the year. “The potential of improved financial performance should be an encouragement for many organizations to purchase and use an EHR,” said William Jessee, president and CEO of MGMA in a statement.

The results, detailed in the report Electronic Health Records Impacts on Revenue, Costs, and Staffing: 2010 Report Based on 2009 Data, also points out that multispecialty hospital/IDS-owned practices with an EHR, while not quite achieving the results of their unaffiliated counterparts, also realize better operating margins than those without at just over $42,000 in 2009.

The report indicated that while an EHR’s expense was quite high during the first year, other operating expenses tended to decline. In fact, non-hospital/IDS owned practices realized 10 percent greater operating margin in their fifth year with an EHR than the first.

“Adopting an electronic system can be costly and time consuming, and understanding the impact it will have on the practice is critical,” said William F. Jessee, MD, FACMPE, CEO of MGMA in a statement. “While the implementation process can be very cumbersome, these data indicate that there are financial benefits to practices that implement an EHR system.”

While IT staffing per FTE physician increased moderately after five years with an EHR (0.13 to 0.15), practices were able to reduce medical records and transcription staff by 44 percent, resulting in significant savings on labor.

Although increasing numbers of practices are looking to automate their medical records in light of financial incentives from Medicare under the federal stimulus package, proving “meaningful use” of the technology—a requirement for practices to receive up to $44,000 in funding to help offset EHR implementation costs—still presents a challenge for many medical groups, according to Jessee.

Source    :     http://www.healthleadersmedia.com/page-1/TEC-258327/MGMA-Practice-Revenue-Increases-with-EHRs##

Filed under: EHR, EHR companies, Electronic Health Records on December 21st, 2010 | No Comments »

Independent physician practices can earn nearly $50,000 per full-time-equivalent physician with an EHR than those still stuck in the paper world, the Medical Group Management Association reports.

The report, based on a survey of MGMA membership, found that EHR-equipped practices not owned by hospitals or integrated delivery networks had $178,907 in higher median revenue per FTE physician in 2009 than similar practices without an EHR. Though operating costs were $105,591 higher per doctor with an EHR, the net result was $49,916 greater operating income for each FTE physician.

Multispecialty practices owned by hospitals or IDNs did nearly as well, reporting a mean $42,042 higher operating margins with EHRs than without, according to the MGMA, which released the study Monday at the organization’s annual conference in New Orleans.

Benefits tend to rise over time, as well. Independent practices that have had EHRs more than five years had operating margins 10.1 percent greater than practices in their first year of EHR usage. That is largely because the highest implementation expenses tend to occur in the first year, after which time practices often see costs go down for transcription and medical records staff.

“Adopting an electronic system can be costly and time consuming, and understanding the impact it will have on the practice is critical,” said MGMA President and CEO Dr. William F. Jessee said in a prepared statement. “While the implementation process can be very cumbersome, these data indicate that there are financial benefits to practices that implement an EHR system.”

Still, Jessee said he expects many practices to struggle in their quest to earn Medicare and Medicaid incentive payments for “meaningful use” of EHRs starting in 2011.

Source  :   http://www.fierceemr.com/story/mgma-ehrs-improve-bottom-line-physician-practices/2010-10-28

Filed under: EHR, EHR companies, Electronic Health Records on December 3rd, 2010 | No Comments »